Individual
JANS BYEL BUENO RAYMUNDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8427 102ND AVE, OZONE PARK, NY 11416-2028
(929) 698-6616
Mailing address
8427 102ND AVE, OZONE PARK, NY 11416-2028
(929) 698-6616
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
01396101
NY
Other
Enumeration date
11/08/2023
Last updated
11/08/2023
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